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Two kids with autism = sensory issues at this dinner table

One son’s munching drives quiet-craving brother crazy; our expert has strategies for building tolerance and restoring peace 

“We have two sons affected by autism, ages 11 and 6. Our eldest likes quiet, while our little one is noisy and active. This is a major mealtime problem because my eldest can’t stand my little one’s munching. We bought headphones, but still our older son can hear and keeps glaring at his little brother. The little one tries to chew with his mouth closed; but his nose is often blocked, so he needs to open his mouth. In the morning, when we’re in a rush, I just feed them separately. Is there any way to help our 11-year-old be more tolerant of his brother’s chewing so we can eat peacefully together?”

This week’s “Got Questions?” answer is by child psychologist Michelle Spader, of Ohio’s Nationwide Children’s Hospital, one of 14 centers in the Autism Speaks Autism Treatment Network.

Editor’s note: The following information is not meant to diagnose or treat and should not take the place of personal consultation, as appropriate, with a qualified healthcare professional and/or behavioral therapist.

Keeping mealtime peaceful can certainly be difficult when family members have different preferences. As you may know, sensory sensitivities are quite common among children who are affected by autism.

I commend your attempt to improve the situation by giving your older child headphones and sometimes feeding your boys separately. On busy mornings, your separate-meals approach may be the wisest solution – at least for now.

At a less stressful time of day, I have several strategies you can use to build your older child’s tolerance to his brother’s chewing.

Typically, we help children overcome sensory issues with an approach we call systematic desensitization. In essence, we help them build tolerance to bothersome sensations – be it noises, textures or even tastes – by helping them take small steps toward interacting with the irritation.

To start, I suggest planning a short, daily practice session. Plan to spend 3 to 5 minutes. Call it something fun. Maybe “The Chewy Challenge Championship.”

To prepare, please gather the following materials:

* Audio or audio-visual clips of someone chewing. These are easy to find with an Internet search. Just search “chewing sounds” and “videos,” and you’ll be amazed! (See one example below.) Another option is to record the sound of your younger son chewing.

 

* Small rewards. Think about what motivates your eldest. M&Ms or small portions of a favorite snack? Stickers? Reward tokens that he can collect to cash in for a larger reward?

Another reward system we sometimes use is a favorite video that can be stopped at short intervals without causing a fuss. In this case, each “success” would earn your son, say, 15 seconds with the video before returning to the next step in your practice session.

Now you’re ready to begin.

Practice audio clips
Ask your older son to sit with you for the Chewy Challenge Championship, and ask him to try to remain calm while you play one of the audio clips at a very low volume for 2 or 3 seconds. Reward him for staying calm while listening by giving him praise and the small treat, token or a segment of the reward video.

Repeat this exercise with the audio clip at low volume for a few seconds longer – say for 4 seconds and then 6 seconds, building up to 10 seconds. Each time your son is able to remain calm, provide praise and the reward.

Remember to keep the sessions short – no more than 5 minutes of exposure per day. Try to end each session with calm behavior.

When your son can tolerate 10 seconds at the low volume, increase the volume slightly and drop back to 2 or 3 seconds. Then remain at this volume as you build the time to 4, 6 and 10 seconds as you did before.

Remember to provide praise and a reward each time your son is able to tolerate the sound with reasonably calm behavior.

Repeat this daily exercise for several days, or longer if needed, to reach a goal of listening to a one-minute audio clip at normal, or “real life,” volume.

Next, it’s time to start working with your two boys together. 

Practice snacks
Plan a short snack session with your two boys in the same room. Having them at the same table is ideal, but you may need to build up to that.

If possible, start with foods that are relatively less irritating to your older son. Again, you know his sensitivities best. Are crunchy sounds – such as crackers and chips – the hardest for him to tolerate? Or is he worse with slurpy or sticky food sounds?

Keep the portion quite small at first – enough for your boys to finish eating in under a minute.

Reward both sons for sitting calmly and finishing the snack. The reward might be a favorite activity that they both enjoy, but separate activities are fine too.

With each success, gradually increase the amount of food and try different types of foods. The goal is for your sons to snack together peacefully for three to five minutes.

Mealtime behavior
At the same time that you’re helping your eldest overcome his sensory issues, it’s important to encourage both your boys to master calm mealtime behavior. Here again, I suggest developing a reward system such as tokens, stickers or a favorite activity after the meal.

I also recommend spelling out what you mean by “calm mealtime behavior.” This can include

* Quiet voice

* Keeping hands to one’s self

* Staying seated

As many children with autism do best with visual cues, it can help to illustrate these mealtime rules. You can print out pictures from the Internet – or even better, ask your sons to draw and/or color some illustrations.

Learn more about visual supports and download the Autism Speaks ATN/AIR-P Visual Supports Tool Kit here.

I hope these strategies prove helpful. Please let us know how you and your family members are doing in the comment section below or by emailing us again at gotquestions@autismspeaks.org.

Readers: We’d love you to share your tips as well in the comment section below.

Got more questions for our behavioral and medical experts? Send them to GotQuestions@AutismSpeaks.org.
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The Autism Speaks blog features opinions from people throughout the autism community. Each blog represents the point of view of the author and does not necessarily reflect Autism Speaks' beliefs or point of view.